4. Should the United Kingdom make greater
use of vaccines to combat infection and what problems exist for
developing new, more effective or safer vaccines?

Universal Hepatitis B immunisation should be
incorporated into the childhood immunisation programme with a
catch up programme for adolescents. Whilst we acknowledge the
financial burden of this proposal we consider that there will
be considerable savings in terms of the management of cases and
the follow up of their contacts. The selective programme is inconsistent
across the country, costly and time consuming to implement and
no financial incentives exist nationally to promote and implement
it within Primary Care.

5. What infectious diseases pose the bigger
threats in the foreseeable future?

Blood borne viruses and sexually transmitted
diseases pose the biggest threats now and in the foreseeable future.
The financial implications of implementing the Hepatitis C strategy
must be addressed especially with regard to the treatment and
follow up of cases, which will necessitate an increased demand
for specialist workers in addition to the costs associated with
therapy.

6. What policy interventions would have the
greatest impact on preventing outbreaks of and damage caused by
infectious disease in the United Kingdom?

There is an urgent need to increase investment
in sexual health services both in relation to treatment and prevention.
Health promotion must retain a high profile within the school
curriculum. Current epidemiological data suggests that the "safer
sex" messages of the 1980s have lost their impact and need
reinforcing.

Needle exchange schemes need to be expanded
and consideration should be given to providing "paraphanalia"
in addition to needles to minimise sharing and consequently reduce
the risk of transmission of Hepatitis C. This should include the
recognition that policy relating to prisons and prison health
needs immediate review. The need for needle exchange facilities
and condom distribution initiatives within prisons will have an
impact upon the spread of blood borne viral infections in particular
the threat posed by Hepatitis C infection.

HIV and tuberculosis will continue to impose
significant morbidity and mortality. Investment is required to
increase the availability of rapid diagnostic facilities for both
tuberculosis and HIV.